Can Jeremy Hunt keep his promise about doctors?

Health Secretary Jeremy Hunt was short on detail when he said he would restore
old-fashioned access to GPs

The Health Secretary Jeremy Hunt has said he is committed to restoring 'old-fashioned family doctoring'Photo: Geoff Pugh

By James Le Fanu

6:53PM GMT 24 Nov 2013

The commitment by Jeremy Hunt, the Health Secretary, last week to restore “old-fashioned family doctoring” is welcome, though the practical details of the elderly having “a dedicated GP personally accountable for their care around the clock” have yet to be spelt out. Just making an appointment at the local surgery can, as many will know, be a Herculean task, so it would be nothing short of a miracle if, as promised, patients will be able to contact their doctor “at all times of the day or night”.

When interrogated about this on the BBC’s Today programme, Hunt responded, as Matthew Norman observed in this paper, with “seven minutes of undiluted vagueness”.

Still, the rationale of the proposed changes is reasonable enough – to liberate GPs from at least some of the time-wasting, box-ticking rituals required by their current contracts, thus freeing up their time and energy to offer “personal care”.

Eye's right

The effortless, balletic movement of the three antagonistic pairs of eye muscles swivelling in perfect unison, from left to right, up and down, is a marvel of mechanical ingenuity. The paralysis or weakness of one or other, resulting in a squint, is a double misfortune, not only because the appearance of being cross-eyed can be so disquieting, but also because it compromises binocular or depth perception. Hence the necessity for its surgical correction in early infancy.

It was not until the early Eighties that surgeons at London’s Moorfields Eye Hospital showed that adults, too, can benefit from surgery – or the judicious use of Botox injections – to rebalance the eye muscles.

The honorary consultant surgeon Hugh Williams has recently produced an excellent DVD, Turning a Blind Eye, which explores the history of this condition and its treatment. It is available free to Telegraph readers by e-mailing reception@rcophth.ac.uk.

Stomach solutions

The consensus from readers concerning the sudden onset of palpitations and churning of the stomach associated with a modest increase in effort (e.g. swinging a golf club or lifting the grandchildren) attributes it to a disturbance of heart rhythm. The extra effort, it is suggested, raises the pressure within the abdomen, which squeezes the heart within the chest cavity to initiate an episode of tachycardia (a cardiac rhythm disturbance), or atrial fibrillation, one of the most common cardiac arrhythmias.

The respiratory physician John Moore-Gillon, of St Bartholomew’s Hospital, London, points out that this effort-induced rise in intra-abdominal pressure can cause the release of heart-rate-increasing chemicals from a carcinoid or carotid body tumour.

By contrast, the neuroscientist Deborah Castle suggests that pressure on the vagus nerve may be the culprit, as it exits the spinal cord in the neck on its way to innervate both heart and stomach. She commends regular neck extension exercises as practised during yoga or Pilates as a preventive measure – “touching chin to chest and then moving it as far back as possible”.

Book allergy

This week’s medical query comes courtesy of Mr GR from Mitcham, Surrey, who, at the age of 70, has seemingly become allergic to books. Within minutes of beginning to read, he starts itching, first on the face, neck and scalp, then virtually everywhere else – irrespective of whether the book is old or new, hardback or paperback.

“It is so unpleasant, I have to abandon my reading,” he writes. His consultant skin specialist could offer no explanation, and neither moisturising creams nor antihistamines improve matters.